Insurance Assistance
Helping Hands™ Reimbursement Support
Navigating insurance coverage is not always easy. Through Helping Hands™, our team of dedicated reimbursement experts can help guide parents through the process from start to finish. From benefits verification to prior authorization assistance, we handle all the details so patients can get quick access to Mead Johnson Nutrition products when prescribed. See form for details about eligible products.
Helping Hands™ Reimbursement Support
Enrollment Form - SPANISHNutramigen® Letter of Medical Necessity
Nutramigen® is a 20 cal/fl oz, hypoallergenic formula with extensively hydrolyzed protein and LGG probiotic for infants with food allergies including cow’s milk allergy. Use this form for patients prescribed Nutramigen® with Probiotic LGG®.Nutramigen® Toddler Letter of Medical Necessity
Nutramigen® Toddler is a 20 cal/fl oz, hypoallergenic toddler formula with extensively hydrolyzed protein and LGG probiotic for children with food allergies, including cow’s milk allergy. Use this form for patients prescribed Nutramigen® with Probiotic LGG® Toddler.PurAmino® Letter of Medical Necessity
PurAmino® is a 20 cal/fl oz, hypoallergenic amino acid-based formula for infants with severe cow’s milk protein allergy and multiple food allergies or elemental diet needs such as fat malabsorption, multiple food protein allergies, food protein-induced enterocolitis syndrome (FPIES), eosinophilic esophagitis (EoE),* and short bowel syndrome. Appropriate for both oral and tube feeding. Use this form for patients prescribed PurAmino®.
PurAmino® Jr Letter of Medical Necessity
PurAmino® Jr is a 30 cal/fl oz, nutritionally complete,* hypoallergenic, amino acid-based medical food for the dietary management of children, 1 year and up, with severe cow’s milk protein allergy. PurAmino® Jr is also indicated for the dietary management of children with multiple food protein allergies. It may also be suitable for conditions requiring an elemental diet, such as protein maldigestion, malabsorption, short bowel syndrome, food protein-induced enterocolitis syndrome (FPIES) and eosinophilic esophagitis (EoE). Appropriate for both oral and tube feeding. Use this form for patients prescribed PurAmino® Jr.
Pregestimil® Letter of Medical Necessity
A hypoallergenic formula with MCT oil for infants with fat malabsorption or who may be sensitive to intact proteins, fat malabsorption may be associated with short bowel syndrome, intractable diarrhea and severe protein calorie malnutrition.Metabolic Products Letter of Medical Necessity
Metabolic formulas are considered a medical necessity for infants, children, and adults with inborn errors of metabolism. These metabolic products offer tailored nutritional support from infancy through adulthood. Use this form for patients prescribed maple syrup urine disease (BCAD 1, 2), glutaric acidemia (GA), homocystinuria (HCY 1, 2), lactic acidosis (LMD), organic acidemias (OA 1, 2), propionic acidemia (PFD 2/ 2 toddlers), phenylketonuria (phenyl-free 1, 2, 2 HP), tyrosinemia (tyros 1, 2), and urea cycle disorders (WND 1, 2). Each formula is meticulously formulated to meet the unique dietary requirements of individuals with these conditions, providing essential nutrients while managing intake of specific amino acids or compounds.Enfamil NeuroPro™ EnfaCare® Letter of Medical Necessity
Enfamil NeuroPro EnfaCare is a milk-based, 22 Cal/fl oz, iron-fortified, post-discharge formula that has enriched nutrition for infants who were born prematurely or with low birth weight,† with vitamin and mineral amounts specially tailored for premature babies’ first year of life after discharge from the hospital. Use this form for patients prescribed Enfamil NeuroPro EnfaCare.
*Dietary reference intakes include a recommendation for fiber for >12 months of age.
+Increased caloric density, protein and some vitamins and minerals compared to standard term formula to help support weight and growth in babies born prematurely.